Endocrinology and Metabolism

Case Reports

A Case of Adrenocortical Adenoma Associated with Incidental Pheochromocytoma.: Sung Jun Hong, Young Sik Choi, Yo Han Park, Byung Cheol Yoon, Young Hwan Bae, Seon Ja Park, Ja Young Koo; J Korean Endocr Soc. 1996;11(4):531-537. Published online November 7, 2019

Abstract PDF: The coexistence of adrenal cortical tumor and pheochromocytoma was extremely rare. A total of 25 reported cases showing evidence of hyperfuction of the adrenal cortex and pheochromocytoma were noted in the literature. Of those twenty cases were coexistence of pheochromocytoma and adrenocortical hyperplasia and only five cases were coincident pheochromocytoma and adreno-cortical adenoma. Recently, we experienced a case of adrenocortical adenoma associated with incidental pheochrmocytoma. A 55-year-old woman complained of progressive weight gain and epigastric discomfort. Hormonal and radiologic studies revealed Cushings syndrome with a left adrenal tumor. Adrenalectomy was performed and the gland actually had two nodules on its surface, one pheochromocytoma and the other cortical adenoma. This patient was the first case of pheochromocytoma with adrenocortical adenoma in Korea. We report the case with a review of literature.

A Case of Bilateral Macronodular Adrenocortical Hyperplasia.: Yoon Sang Choi, Soo Mi Kim, Shin Gon Kim, Ie Byung Park, Sei Hyun Baik, Dong Seop Choi, Seung Woon Rha, Dong Hyun Shin; J Korean Endocr Soc. 1996;11(4):523-530. Published online November 7, 2019

Abstract PDF: Cushing's syndrome associated with nodular adrenal glands will be divided into four main categories: adrenal adenoma, adrenal carcinoma, primary pigmented nodular adrenal dysplasia (PPNAD) and macronodular adrenal hyperplasia(MAH). The term macronodular adrenal hyperplasia is restricted to the presence of multiple nodules visible to the naked eye, ranging in size from 0.5 to 7.0 cm. We report a case of Cushings syndrome caused by bilateral macronodular adrenal hyperplasia (MAH). A 45-year-old man presented with Cushingoid features, hypertension and diabetes mellitus. Urine free cortisol was 449.9 mmol/day(27-276) and were not suppressed after administration of low-dose and high-dose dexamethasone. Plasma ACTH was very low(1.87 pmol/L(18)) and was not stimulated by administration of ovine CRH. In abdominal CT, both adrenal glands were markedly enlarged and nodular in appearance. Pituitary MRI showed no abnormal finding. Bilateral adrenalectomy was done. Histologic examination revealed multiple nodules and internodular hyperplasia. This case and other reports suggested that because of variable biochemical, radiologic and pathologic findings, macronodular adrenal hyperplasia represents a heterogeneous group of patients with varying degrees of adrenal autonomy.

A Case of Normal Full Term Delivery after Afrenalectomy for Cushing's Syndrome in a Pregnant Patient.: Sung Sik Yang, Yong Seong Kim, Yong Bum Cho, Young Wan Kim, Seong Bin Hong, Yeo Joo Kim, Mi Rim Kim, Moon Suk Nam, Sei Joong Kim, Suk Hwan Shin, Byoung Ick Lee; J Korean Endocr Soc. 1999;14(3):562-567. Published online January 1, 2001

Abstract PDF: We experienced a case of Cushings syndrome due to adrenal adenoma associated with pregnancy 23th week in a 26 year old female patient. On physical findings, hypertension, moon face, hirsutism, abdominal striae and buffalo hump were noticed. Laboratory findings showed increased serum cortisol, increased 24 hours-urinary cortisol, and decreased plasma ACTH. Abdominal MRI demonstrated 4 cm sized in long diameter, well marginated, and ovoid-shape right adrenal mass. Unilateral total adrenalectomy was performed at the 23th week of pregnancy and the mass it was confirmed to benign adrenal adenoma. Steroid replacement therapy was continued with 7.5 mg prednisolone during remaining pregnancy. At the 38th week of pregnancy, labor was developed and she delivered healthy female weighing 2.5 kg through normal vaginal delivery without complication. Pregnancy rarely occurs in patients with Cushings syndrome. We think she was the first case in Korea who had normal 38th week transvaginal delivery after adrenalectomy in adrenal Cushings syndrome during pregnancy.

A Case of Black Adrenocortical Adenoma Causing Cushing's Syndrome with Contralateral Nonfuncioning Adenoma.: Do Joon Park, Kyung Soo Park, Kyung Jae Nam, Sung Yeon Kim, Bo Yeon Cho, Hong Gyu Lee, Yeo Kyu Yoon, Seung Keun Oh; J Korean Endocr Soc. 1999;14(2):410-417. Published online January 1, 2001

Abstract PDF: We report herein the case of a 38-year-old woman with Cushings syndrome caused by bilateral adrenocortical adenomas. The adrenal tumor on the left side hypersecreted cortisol and no findings of cortisol hypersecretion from the adrenal tumor on the right side were observed on bilateral adrenal vein samplings. Both adrenal tumors were resected and histologically without any findings of nodular hyperplasia. The left adrenal tumor was histologically diagnosed as a so-called black adenoma. These data imply that the adrenal adenomas developed primarily from the adrenal gland itself, and that one of the tumors was well differentiated and secreted excess hormones, while the other remained in cell proliferation without hypersecretion.

A Case of Cushing's Syndrome in Pregnancy due to Adrenal Adenoma.: Hyung Joon Yoo, Sung Hee Ihm, Sung Woo Park, Hae Sung Yim, Yong Tae Kim, Chul Hee Park, Hyun Kyu Kim, Doo Man Kim, Jae Myoung Yoo, Moon Ki Choi; J Korean Endocr Soc. 1998;13(2):264-270. Published online January 1, 2001

Abstract PDF: Cushings syndrome in pregnancy is rare. This is explained by the syndromes association with amencerhea, infertility and abortions. Matemal and fetal risks increase markedly when pregnancy does occur in woman with hypercortisolism. Since pregnant women without Cushings syndrome develop some features of Cushings syndrome, such as hypertension, hyperglycemia and striae, a high index of clinical suspician must be maintained to prevent delay in diagnosis. The physiologic changes in adrenocorticostemid metabolism during pregnancy further complieate the diagnosis. We describe a case of Cushings syndmme in pregnancy secondary to an adrenal cortical adenoma which was diagnosed immediately after a preterm delivery in 24-year-old woman with preeclampsia.

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